公开(公告)号：US5741312A

公开(公告)日：1998-04-21

申请号：US820445

申请日：1997-03-12

申请人： Bernardus F. M. Vonk ,  Geeske van Oort ,  Johannes S. van der Veen

发明人： Bernardus F. M. Vonk ,  Geeske van Oort ,  Johannes S. van der Veen

IPC分类号： A61N1/37 ,  A61N1/362

CPC分类号： A61N1/3712

摘要： There is provided a pacemaker system with capture verification and threshold testing, in which the pacemaker waits after each change in delivered pace pulses for a stabilization interval, in order to minimize polarization and enhance capture verification. The threshold test utilizes a pace pulse pair, comprising a prior search pulse which is varied during the test, and the regular pacing pulse which is above threshold. When delivery of the pulse pairs is initiated, the search pulse is adjusted to optimize polarization, and the pacemaker waits for predetermined stabilization period of time in order to allow for minimum polarization and to optimize capture detection. The search pulse is increased incrementally in output value toward threshold, and following each such increase the pacemaker waits for a stabilization interval. The pacemaker detects when capture is achieved by the search pulse, thereby providing an indication of threshold.

摘要翻译： 提供了具有捕获验证和阈值测试的起搏器系统，其中起搏器在每次改变传送的起搏脉冲之后等待稳定间隔，以便最小化极化并增强捕获验证。 阈值测试利用了一个起搏脉冲对，其包括在测试期间变化的先前搜索脉冲和高于阈值的规则起搏脉冲。 当开始传送脉冲对时，调整搜索脉冲以优化极化，并且起搏器等待预定的稳定时间段，以便允许最小偏振并且优化捕获检测。 搜索脉冲在输出值向阈值逐渐增加，并且随着每个这样的增加，起搏器等待稳定间隔。 起搏器通过搜索脉冲检测何时捕获，从而提供阈值的指示。

公开(公告)号：US5713930A

公开(公告)日：1998-02-03

申请号：US744576

申请日：1996-11-06

申请人： Johannes S. van der Veen ,  Geeske van Oort

发明人： Johannes S. van der Veen ,  Geeske van Oort

IPC分类号： A61N1/362 ,  A61N1/368 ,  A61N1/365

CPC分类号： A61N1/3627 ,  A61N1/3682

摘要： A dual chamber pacemaker system and method is provided for adjusting AV delay to provide for an optimal AV setting for a selected pacing application. In the inventive system and method, the basis for determining the AV delay setting is to perform a ventricular fusion test, wherein variations in QT interval are monitored corresponding to variations in AV interval. Based upon the AV-QT data, the pacemaker can determine the ventricular fusion zone where the pacemaker AV interval is substantially the same as the intrinsic conduction interval, as well as the knee where AV intervals just shorter than the ventricular fusion zone result in full capture. The pacemaker selects a routine for adjusting AV interval depending upon a desired application, including the applications of adjusting AV interval for full capture and for treatment of a HOCM patient. There is also provided a routine for determining an appropriate AV hysteresis value for inhibiting ventricular pacing and allowing ventricular sensing as much as possible, for patients with intermittent AV block.

摘要翻译： 提供了一种双室起搏器系统和方法，用于调节AV延迟以为选定的起搏应用提供最佳的AV设置。 在本发明的系统和方法中，用于确定AV延迟设置的基础是执行心室融合测试，其中根据AV间隔的变化监视QT间期的变化。 基于AV-QT数据，起搏器可以确定起搏器AV间隔与内在传导间隔基本相同的心室融合区以及短于心室融合区的AV间隔导致完全捕获的膝盖 。 起搏器根据所期望的应用选择一个用于调节AV间隔的程序，包括调整AV间隔用于完全捕获和用于治疗HOCM患者的应用。 还提供了用于确定用于抑制心室起搏并且允许对间歇性AV阻滞患者尽可能多地进行心室感测的适当AV滞后值的程序。

公开(公告)号：US6067472A

公开(公告)日：2000-05-23

申请号：US10694

申请日：1998-01-22

申请人： Bernardus F. M. Vonk ,  Geeske van Oort

发明人： Bernardus F. M. Vonk ,  Geeske van Oort

IPC分类号： A61N1/37 ,  A61N1/362

CPC分类号： A61N1/3712 ,  A61N1/3716

摘要： There is provided a pacemaker system with capture verification and threshold testing, in which the pacemaker adjusts the post-stim pulse portion of a triphasic pulse to minimize polarization, and waits after each change in delivered pace pulses for a stabilization interval, in order to enhance capture verification. The threshold test utilizes a pace pulse pair, comprising a prior search pulse which is varied during the test, and the regular pacing pulse which is above threshold. When delivery of the pulse pairs is initiated, the search pulse is adjusted to optimize polarization, and the pacemaker waits for a predetermined stabilization period of time in order to allow for minimum polarization and to optimize capture detection. The search pulse is increased incrementally in output value toward threshold, and following each such increase the pacemaker waits for a stabilization interval. The pacemaker detects when capture is achieved by the search pulse, thereby providing an indication of threshold. The polarization minimization feature involves scanning the post-stim duration to find the optimal duration. The polarization minimization also enables detection of repolarization signals, and consequent pacemaker functions such as AAIR pacing and suppression of atrial tachycardia.

摘要翻译： 提供了具有捕获验证和阈值测试的起搏器系统，其中起搏器调节三相脉冲的刺激后脉冲部分以最小化极化，并且在传输的步态脉冲的每次改变之后等待稳定间隔，以便增强 捕获验证。 阈值测试利用了一个起搏脉冲对，其包括在测试期间变化的先前搜索脉冲和高于阈值的规则起搏脉冲。 当开始传送脉冲对时，调整搜索脉冲以优化极化，并且起搏器等待预定的稳定时间段，以便允许最小偏振并优化捕获检测。 搜索脉冲在输出值向阈值逐渐增加，并且随着每个这样的增加，起搏器等待稳定间隔。 起搏器通过搜索脉冲检测何时捕获，从而提供阈值的指示。 极化最小化特征涉及扫描刺激后持续时间以找到最佳持续时间。 极化最小化还能够检测复极化信号，以及随后的起搏器功能，如AAIR起搏和抑制心房心动过速。

公开(公告)号：US5954754A

公开(公告)日：1999-09-21

申请号：US850471

申请日：1997-05-05

申请人： Gustaaf A.P. Stoop ,  Geeske van Oort

发明人： Gustaaf A.P. Stoop ,  Geeske van Oort

IPC分类号： A61N1/05 ,  A61N1/37

CPC分类号： A61N1/056 ,  A61N1/3712 ,  A61N1/3714

摘要： There is provided a pacing system, preferably a VDD system having a single pass lead with one or two ventricular electrodes and a pair of atrial electrodes. The pacemaker has timing and logic capability for determining when an atrial back-up pulse, such an atrial synchronization pulse, can be delivered, and also whether the pacemaker can provide for continuing atrial pacing. The pacemaker is provided with a plurality of modules for determining the likelihood that a delivered atrial pace pulse resulted in atrial contraction, and for storing data relating to the probable capture or no.sub.-- capture result of each delivered pace pulse. One of the capture-determining modules is a timing module which stores a plurality of rules by which a sequence of events and rates surrounding a delivered atrial pace pulse is analyzed to determine the probability of capture. The pacemaker carries out capture probability determinations following each delivered pace pulse, and on the basis of such continuous determinations evaluates atrial pace pulse capture efficiency, and adjusts the atrial pace pulse output level to optimize atrial pacing.

摘要翻译： 提供了一种起搏系统，优选地具有具有一个或两个心室电极和一对心房电极的单程导联的VDD系统。 起搏器具有时间和逻辑能力，用于确定什么时候能够递送心房支持脉搏（例如心房同步脉冲），以及心脏起搏器是否可以提供持续的心房起搏。 起搏器设置有多个模块，用于确定递送的心房起搏脉冲导致心房收缩的可能性，并且用于存储与每个传送的步调脉冲的可能的捕获或非捕获结果有关的数据。 捕获确定模块之一是定时模块，其存储多个规则，通过该规则分析围绕传送的心房起搏脉冲的事件和速率序列以确定捕获的概率。 起搏器在每个传送的步调脉冲之后执行捕获概率确定，并且在这种连续测定的基础上评估心房起搏脉冲捕获效率，并且调整心房搏动脉搏输出水平以优化心房起搏。

公开(公告)号：US5720769A

公开(公告)日：1998-02-24

申请号：US744090

申请日：1996-11-05

申请人： Geeske van Oort ,  Gustaaf A. P. Stoop

发明人： Geeske van Oort ,  Gustaaf A. P. Stoop

IPC分类号： A61N1/365 ,  A61N1/00

CPC分类号： A61N1/36542

摘要： There is provided a rate responsive pacemaker system and method employing an activity-type sensor for deriving signals for determining pacing rate, wherein the activity sensor threshold is automatically adjusted as a function of monitored sensor output. In a preferred embodiment, activity counts are categorized on a histogram basis, and the histogram data is stored over a selected period of time. The activity data in histogram form is then analyzed and compared to predetermined criteria to determine whether threshold seems to be proper, or whether threshold adjustment is indicated. The adjustment algorithm provides different degrees of adjustment depending upon the circumstances. Specifically, where the data suggests too many or too few counts within an expected range, the threshold is adjusted as a function of whether the analyzed outputs are only a little bit out of the expected range or quite a bit out of the expected range. The algorithm also determines whether the sensor response accurately reflects patient rest. Another specific feature of the invention is determination of when the sensor is picking up false positives and thus improperly responding to extraneous signals such as patient's cardiac contractions.

摘要翻译： 提供了一种速率响应起搏器系统和方法，其使用活动型传感器来导出用于确定起搏速率的信号，其中根据监测的传感器输出自动调整活动传感器阈值。 在优选实施例中，活动计数按直方图进行分类，并且在所选择的时间段内存储直方图数据。 然后分析直方图形式的活动数据，并将其与预定标准进行比较，以确定阈值是否合适，或者是否指示阈值调整。 调整算法根据情况提供不同程度的调整。 具体来说，在预期范围内数据暗示太多或太少计数的情况下，根据所分析的输出是否只有一点点超出预期范围或者远远超出预期范围，调整阈值。 该算法还确定传感器响应是否准确反映患者休息。 本发明的另一具体特征是确定传感器什么时候拾取假阳性，从而不适当地响应诸如患者心脏收缩的外来信号。

公开(公告)号：US20080183085A1

公开(公告)日：2008-07-31

申请号：US11669345

申请日：2007-01-31

申请人： Geeske van Oort ,  Willem Boute ,  Gustaaf A.P. Stoop

发明人： Geeske van Oort ,  Willem Boute ,  Gustaaf A.P. Stoop

IPC分类号： A61B5/00

CPC分类号： A61N1/3621 ,  A61N1/3627 ,  A61N1/3925

摘要： An implantable medical device uses a method for dynamically managing physiological signal monitoring. A physiological signal is sensed for detecting physiological events in response a first threshold. A determination is made whether a second threshold has been met in response to detecting physiological events. If the second threshold has been met, detailed monitoring of the physiological events is enabled.

摘要翻译： 可植入医疗装置使用动态管理生理信号监测的方法。 感测生理信号以响应于第一阈值检测生理事件。 确定响应于检测到生理事件是否满足第二阈值。 如果满足第二个阈值，则可以对生理事件进行详细监测。